Gonzalo Benavides Estrada Jr., PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT17835 Issued in CA

Practice address

Hazel Hawkins Rehab. Services
961A Sunset Drive
Hollister, CA 95023

Phone

(831) 635-1135

Fax

(831) 636-9547

NPI assigned

Dec 7, 2023

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Jun B Estrada Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Hazel Hawkins Memorial Hospital

  • General Acute Care Hospital
  • Hollister, CA
  • NPI 1275578817
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1701907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1730956905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HAZEL HAWKINS REHAB. SERVICES",
            "address_2": "961A SUNSET DRIVE",
            "city": "HOLLISTER",
            "state": "CA",
            "postal_code": "95023",
            "telephone_number": "831-635-1157",
            "fax_number": "831-636-9547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "HAZEL HAWKINS REHAB. SERVICES",
            "address_2": "961A SUNSET DRIVE",
            "city": "HOLLISTER",
            "state": "CA",
            "postal_code": "95023",
            "telephone_number": "831-635-1135",
            "fax_number": "831-636-9547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESTRADA",
        "first_name": "GONZALO",
        "middle_name": "BENAVIDES",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-12-07",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT17835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JUN",
            "last_name": "ESTRADA",
            "middle_name": "B",
            "credential": "PT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Aloysius Ojong Arrey Enow
• Becky Escamilla
• Marian Essa
• Annette Sison Estrada, PT, DPT
• Desiree Estrada
• Miriam Jeanette Estrada
• Paula Estrada, RN
• Angelica Mae Evans, OTR/L
• Faranak Fahimipour, DDS
• Allison Fahy, R.N., B.S.N., P.H.N.

• Physical Therapist in Hollister, CA
• Providers in Hollister, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.